title: Massive gas embolism revealed by two consecutive postmortem computed-tomography examinations.
abstract: We present a case of unusual gas embolism in a 73-year-old man who was found in a state of cardiopulmonary arrest with an oxygen-supply tube connected to an intravenous catheter inserted into his median cubital vein. Postmortem computed tomography (PMCT) performed 27 h after death showed systemic gas distribution including intravascular gas, pneumothorax, pneumoperitoneum, pneumomediastinum, pneumoretroperitoneum and gastric emphysema. A second PMCT scan performed 116 h after death showed a marked decrease of air inside the body. The current case shows the importance of PMCT for visualization, quantification, and preservation of evidence for establishment of the cause of death in cases with suspected gas embolism. Our findings also indicate that performance of two PMCT examinations may be useful for differentiation of embolized gas from gas produced by putrefaction.
authors.affiliation: Department of Legal Medicine, Graduate School of Medicine, Chiba University, Inohana 1-8-1,Chiba City, Chiba Prefecture 260-8670, Japan. ymakino-tky@umin.ac.jp
authors.forename: Yohsuke
authors.initials: Y
authors.lastname: Makino
authors.forename: Ryota
authors.initials: R
authors.lastname: Shimofusa
authors.forename: Mutsumi
authors.initials: M
authors.lastname: Hayakawa
authors.forename: Daisuke
authors.initials: D
authors.lastname: Yajima
authors.forename: Go
authors.initials: G
authors.lastname: Inokuchi
authors.forename: Ayumi
authors.initials: A
authors.lastname: Motomura
authors.forename: Hirotaro
authors.initials: H
authors.lastname: Iwase
mesh_terms: D000368:Aged; D002408:Catheters, Indwelling; D004618:Embolism, Air / Q000000981:diagnostic imaging* / Q000473:pathology; D004646:Emphysema / Q000000981:diagnostic imaging / Q000473:pathology; D049429:Forensic Pathology; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008478:Mediastinal Emphysema / Q000000981:diagnostic imaging / Q000473:pathology; D061330:Multidetector Computed Tomography; D010102:Oxygen Inhalation Therapy; D035422:Pleural Cavity / Q000473:pathology; D011027:Pneumoperitoneum / Q000000981:diagnostic imaging / Q000473:pathology; D011030:Pneumothorax / Q000000981:diagnostic imaging / Q000473:pathology; D012188:Retropneumoperitoneum / Q000000981:diagnostic imaging / Q000473:pathology; D012611:Scrotum / Q000473:pathology; D013270:Stomach / Q000000981:diagnostic imaging / Q000473:pathology; D013405:Suicide; D051598:Whole Body Imaging
keywords: Air embolism; Forensic pathology; Forensic radiology; Gas embolism; Postmortem computed tomography